Endodontic therapy (more commonly known as a root canal) is usually performed on patients where the cause of their dental pain is the inflammation or infection of the tissues in the nerve chamber of the tooth. This process commonly occurs when bacteria sneaks its way into the nerve chamber of the tooth and causes lasting damage. A neglected tooth is the prime suspect for this type of tooth decay to start—and this kind of infection can also occur beneath old, worn fillings.
Other reasons for performing a root canal include a fracture of a tooth that has led to the exposure of the nerve chamber, or a tooth with dead or dying tissue in the nerve chamber from chronic trauma to the tooth.
ROOT CANAL THERAPY
After a dose of anesthesia is established, any decay and old restoration is removed so that the tooth can be evaluated to see if it is restorable. Once the tooth is determined to be able to be restored, access into the chamber of the tooth is established. This means all the tissue—including the nerve, blood supply, and associated bacteria—is removed from the chamber. The goal is to reestablish a sterile environment in the tooth.
Root canal therapy is routinely done in two appointments. If this is the case, medication is place inside the tooth to help reduce the infection that can sometimes lurk in the surrounding structures of the tooth. On the second appointment, the tooth is cleaned out again, and if the tooth is in good shape, it is then sealed to help prevent reinfection of the chamber. A crown, which is discussed on our restorative page, is then placed to support the tooth.
RETREATMENT OF ROOT CANAL THERAPY
On occasion, the initial root canal can become infected. If this happens, the case is evaluated for potential causes, and if determined that the old filling material is the source, it might be removed and a new sealer placed. If a crown is present, the access opening is usually established through the crown, and a composite is placed following the retreatment.
Occasionally, the source of infection cannot be cleaned out from an access through the crown. When this is the case, the patient is set up for endodontic (root canal) surgery. On the day of the surgery, the patient is anesthetized, and the bone adjacent to the source of infection is exposed. A minimal access point through the bone is established, the infection cleaned out, and the canal is sealed at the tip of the root. The majority of the time, this procedure is done by an endodontist.